Over the sea to Skye…… and other places

Advising architects, trialling trikes and travelling over the sea to Skye is all part of the average week of

Highland Council Children’s Occupational Therapist Susan Jeffrey.


I am a Band 6 Occupational Therapist (OT), working for The Highland Council as part of their Health and Social Care Children’s Service.  Based in Fort William with a geographical patch covering Lochaber, Skye and Lochalsh.  I have been an OT for 21 years, and a children’s OT for 18 of those years. I’ve worked in Highland for the last seven.

Our OT team is based and managed from Inverness where the majority of the Children’s OTs are located.  After almost seven years as a lone practitioner I was joined by a Band 5 OT last October – at last I have someone to share the highs and lows of the OT world in our locality.

We are based out of Fort William Health Centre – which opened in 2007.  A fantastic local facility from which to deliver our service with co-location with other therapy and health colleagues.

The world of the Children’s OT has changed a lot since I started with a real drive these days to  improve the skills of those around the child including parents, carers, and school staff.To give a flavour of what I do I’d like to share my week:

Slide1Starts with a weekly look at new referrals and allocation of children from the waiting list onto the caseload.  Our team have a central point of referral so all new requests go to our team leader in Inverness.  Held a discussion around the challenges of engaging families in therapy; pressures of modern family life and how we manage attendance and non-attendance.

Complete paperwork for alterations to be made to a lycra suit we have for a nursery-aged child.  We use these a lot with our children who have Cerebral Palsy to help their motor control and posture.  In this instance it is to help with joint hypermobility and low muscle tone. These are bespoke made to measure garments. This time we didn’t get it quite right – funny how children have this annoying habit of growing!

New patient clinic – We share our clinic space with the adult services physiotherapy team so a quick room set up and we are ready.  We see children jointly (Band 5/6 learning opportunity) that way we get time to gather information from both the child and family, something that was harder to achieve when assessing on your own.  Today we had three new patients.  First in – a 3rd year high school pupil – referred by their school for poor handwriting.  Followed by a primary two child and primary five child both referred by the Paediatrician for motor control difficulies.

Our assessment involves using standardised and non-standardised materials to ascertain what the underlying difficulty is and what it is that OT can uniquely offer to address this.  We use an occupational performance measure – my new favourite thing – a selection of cards illustrating everyday activities at home and school which we ask the children to rate so they can identlify their own strengths and activites they find challenging.  A great tool to get the child’s perspective and also really helpful in goal setting.


Sees my fortnightly overnight trip to Skye and Lochalsh – check the weather forecast and school closures before setting off. So far the winter weather has been kind and hasn’t disrupted my work planning! Travel from Fort William to  beautiful Skye stopping off to meet up with my Physio colleague and we head north together.  Nursery visit. We have a child with complex physical disability who requires specialist equipment to support sitting, standing and that most important occupation of childhood – play.  We need to look at moving and handling plans too.  Both myself and my physio colleague are moving and handling trainers so are proactive in getting the relevant paperwork drafted during this visit. We will share and support staff with the implementation on our next visit. 


Slide3My second day on Skye. I spend the morning at a primary school.  Working with a primary seven pupil with complex physical and learning difficulties who is transitioning into high school.  Set up some visits for my next trip over and then I am off on the road again.

On the return journey to Fort William I attend a child’s plan meeting in one of our rural schools.  Another child with complex physical and learning needs in a small -teacher rural mainstream school. The remote nature of the geography of this area means that we are often working with children who are placed in their local school. This can at times be challenging for school staff who have little or no experience of children with such significant additional needs – often in contrast to schools in more urban areas where children may be placed with peers who have similar additional needs. 


Slide4Exciting times in Fort William with £36.5million being spent on building three new primary schools on top of the huge investment being spend on Lochaber High School. .  This morning myself and two colleagues are meeting with the architect to discuss the requirements of “our” children.  Hopefully this will help ensure that the new buildings will meet the needs of all pupils.   Lot’s of talk about toilets – as an OT you get used to that!

Also met with our Highland Moving and Handling Coordinator.  We are delivering training to staff from education and social work in the February mid-term so we reviewed the  training content for participants.

Finished off my day with a local home visit. A primary five child who has an Autism Spectrum Disorder (ASD) and sensory processing difficulties.  We are exploring different strategies to help him manage day-to-day situations at home and in school. Being in assembly, PE and sitting still are particularly challenging for this child.


Off to a local primary school this morning.  I am running a trike group (for two pupils) jointly with school personnel.  The children (one with ASD and one with sensory processing difficulties) really enjoy being out on the trike and are so animated pedalling around the playground.  We are a hardy bunch and not put off by a little rain – just as well, this is Fort William after all!

Final visit of the week is to another primary school.  Firstly to give some suggestions and strategies to staff supporting a primary four child with Cerebral Palsy who is struggling a little with pencil skills (writing, drawing and colouring).  We agree a date for me to come back and review. Lastly I catch up with two primary one children who have ASD . I have devised a home and school programme to address toothbrushing, toileting, self-feeding at mealtimes and taking their jacket on and off.  Share the ideas with school staff and a copy goes home for the family. Will catch up with them all in a couple of weeks time.

Back to base for some final housekeeping bits and pieces, check the diary for next week and then … home.


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